Texas Governor Calls Gender-Affirming Care for Trans Youth ‘Child Abuse’

In a directive released Tuesday, the Republican governor called on the general public to report families of trans youth who help their kids access gender affirming care to state authorities.

LGBTQ rights supporters gather at the Texas State Capitol to protest state Republican-led efforts to pass legislation that would restrict the participation of transgender student athletes on the first day of the 87th Legislature’s third special session on Sep. 20, 2021 in Austin, Texas. (Tamir Kalifa / Getty Images)

This past week, Texas Governor Greg Abbott released an order asserting that allowing trans youth to access gender affirming health care constitutes “child abuse.”

While advocates say that the order is not technically legally binding, many worry that it will have negative social and legal ramifications for trans youth and their families in the Lone Star State—where they are already facing a legislative firestorm.

Abbott’s order came in the wake of an opinion from Texas Attorney General Ken Paxton, which claims that several forms of gender-affirming care, including puberty blockers, hormone replacement therapies, and several gender-affirming surgeries (which are generally not performed on minors) fall under the state’s definition of “child abuse.”

Abbott’s follow-up, sent this past Tuesday, directs “licensed professionals” and “members of the general public” to report the parents of minors who help their trans children access gender-affirming care to state authorities. (This proposed enforcement mechanism is reminiscent of the state’s notorious S.B. 8 abortion ban, which also enlists anyone in the state to enforce the law and sue abortion providers.)

The letter also directs the Texas Department of Family and Protective Services (DFPS) to conduct a “prompt and thorough investigation of any reported instances of these abusive procedures in the State of Texas.” 

LGBTQ+ advocates and attorneys have repeatedly emphasized that the letters are not legally binding, and have no basis in law, at a state or national level—no court has ever found gender-affirming care to constitute a form of child abuse.

“This opinion and letter have no legal effect and cannot change Texas law nor usurp the constitutional rights of Texas families,” said Brian Klosterboer, staff attorney at the ACLU of Texas. “But they spread fear and misinformation, and could spur false reporting of child abuse at a time when DFPS is already facing a crisis in our state’s foster care system.”

Many are also concerned about the mental health toll on trans youth, who are already facing a hostile legislative climate. Last year, Texas state legislators proposed 76 anti-LGBTQ+ bills, and passed a sports ban that bars trans youth from playing on the sports team in accordance with their gender. Paxton’s opinion mirrors one piece of failed legislation, which would have made it a felony to provide gender-affirming care to minors. Similar bills have been proposed in over 30 states nationwide since last year.

Several recent studies have demonstrated that gender-affirming care has positive mental health impacts for trans youth—and that those who were allowed to access such care at younger ages have better mental health outcomes as adults

Despite the fact that the orders don’t change the current state laws, some advocates warn that there are circumstances in which the letters could be used as justification for separating trans youth from their families. Experts with the Human Rights Campaign say that there is potential for the ruling to be used against the families of trans kids in family court, where rulings are often sealed, as Canadian LGBTQ+ publication Xtra recently reported

The letters have provoked outcry from Texan politicians and government figures, who have condemned Abbott and Paxton’s actions as well as the anti-trans legislative slate that the Texas GOP has been pushing since last year. State Rep. Erin Zweiner called Abbot’s words “misguided” and “not reflective of the medicinal advice and treatment transgender children receive.” 

“I have had the privilege of meeting and getting to know so many inspiring transgender youth who are simply trying to be kids in a world where too many people make their existence political, and their loving and fierce parents are determined to protect them,” she told Ms. “A cruel target is being placed on these families for the simple motive of political gain.”

Furthermore, the District Attorneys of Texas’s five largest counties have publicly stated that they will not comply with Abbott’s directive, which they called “cruel” and “part of a continued onslaught on personal freedoms.”

This is far from the first time Paxton or Abbott have attacked trans kids—and it’s not even the first time Abbott has called gender affirming care “child abuse.” Last year, amidst the flurry of anti-trans bills directed at trans kids in the Texas legislature, the Texas DFPS released a letter in which commissioner Jaime Masters stated that gender-affirming surgery—which is rarely if ever performed on minors—was “child abuse.” The letter came at the request of Gov. Abbott himself, who at the time likened gender-affirming care to forced sterilization and called affirming surgeries “genital mutilation.” 

Notably, Paxton and Abbott’s stances do not mirror that of the general Texan population. Recent research from PRRI found that as many as two thirds of Texans support nondiscrimination protections for LGBTQ+ people, including majorities across both political parties.

However, trans kids and their parents are feeling increasingly alarmed and discouraged in the face of the political opposition. “To say that it’s scary is an understatement of a lifetime,” said Rachel Gonzales, a member of Parents for Transgender Equality Council and parent of a young trans person, in a recent press call. 

“To know that any person that happens to come across this letter might think that they need to call CPS on loving and supportive parents simply because they don’t understand, and our lawmakers are filling that gap of information that people are experiencing with nothing but lies that are hurting our kids…we’re looking at a potential risk of irreparable emotional harm to our children because of this.”

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Oliver Haug is a social media editor and podcast producer with Ms. magazine. They are also a freelance journalist, focusing on LGBTQ+ issues and sexual politics. Their writing has previously appeared in Bitch Magazine, VICE, them.us, the New York Times' newsletter "The Edit," and elsewhere. You can read more of their work at oliverhaug.contently.com, and follow them on Twitter @cohaug.